Sunday, March 27, 2016

One can boil it all
down to 10 steps for a hospital to join the innovation movement. Doing so will
allow providers to get ahead of the marketplace.
Since innovation and disruption are not
going away anytime soon, hospital leadership may as well break out from the
circle the wagons approach to marketing, planning and management.

Is knowledge power?

We have all read the articles. Heard the dire predictions
and all gone back to doing what we know how to do. When that doesn’t work here
comes the blame/complain game about the market disruptors, and how no one loves
the hospital anymore as if anyone ever
really cared whether the hospital survives.
Those lessons seem to go by the wayside as hospitals repeat the
managerial mistakes of the past which led to the current state. Harsh, yes, but
a statement that carries more truth than some may wish to admit.

Moving forward with innovation

The hospital or health system for that matter can innovate. The reason that providers
are losing the innovation battle and being pushed further down the food chain
comes down to a couple of simple truths.

The innovative disruptors and new entrants have the one
thing that the provider doesn’t. Innovators have a far deeper understanding of,
and a singular focus on meeting the needs of the healthcare consumer and
patient. Within that focus, these very
smart people also understand that they are not in the hospital business, but
the healthcare business. They don’t care if the innovation will decrease hospital
utilization, which is not their concern
as it is a byproduct of the change. It’s
all about meeting the needs of the healthcare consumer and patient.

I would not be worrying so much about what the competitor
down the street is doing. I’d be more worried about what Apple and Google are
doing.

The hospital cannot become an innovator overnight. Though
there are much more than ten steps to transform the hospital into an
innovation machine that is responsive to market needs, many are cultural. The bottom
line is that providers can’t be innovators without the right culture and
focus.

The longest journey begins with the first step

Let’s take that step and transform not only how the hospital
does business but can concentrate not only
just surviving, but growing.

Step 1. With all due respect to various associations and
publications, stop waiting for them to publish an article that gives you
permission to try something or points out
innovation. By the time that the
“experts consultants” expose what you
should be doing, the market has already moved on,
and you most likely are a late adopter. Innovation is about seizing the moment
not reacting to someone else.

Step 2. The hospital has to become the patient-focused and
consumer-focused organization. What that means is that the hospital or health
system has one singular vision and purpose for being, that is meeting the
healthcare needs of the consumer or patient no matter where or how. The requirement is to change the culture from it’s
all about the hospital focus to an external market need focus.

Step 3. Redirect
resources in planning and marketing to an unrelenting focus on market research to
identify and understand the needs of the
health care market. Part of this involves asking and listening to the expressed
needs of the patient and healthcare
consumers. Instead of striving for the home run and flashes of innovative
brilliance, look for the moments and opportunities for incremental innovation.
These will come from an unrelenting focus on the market and individual needs,
not things to do to generate revenue that no one may want or need.

Step 4. Observe. It’s
one thing to ask; it’s another to see and understand how physicians, patients and
the healthcare consumer use the hospital.
Try to see how anyone uses the services. In understanding how they
access and utilize, comes the knowledge to innovate. One will be very surprised
how creatively physicians and patients use the
hospital. Opportunities to innovate will come forth based on actual use.

Step 5. Understand difficulties and complaints. If anyone
has difficulty or complaints about using the hospital, one has a starting point
for innovation. Make the hospital easy to use, eliminate current inconveniences
and introduce improvements to overcome complaints.

Step 6. Learn from
other industries. A good way to innovate on a budget is to learn what other
industries are doing and apply those lessons to the hospital or health
system. If one looks at the pace of
innovation and change in healthcare, the majority of innovation is because
individuals have taken what works in another industry and adapted it to healthcare.

Step 7. Use open innovation. Big consumer products companies
encourage developers to bring novel
products to them. They are flexible on IP protection and give a clear focus on
what is needed. Not bound by the “not invented here” syndrome, hospitals, and health systems could use to
emulate that behavior. Instead of being combative and negative on why an idea
won’t work, understand the why it could work and how the hospital can
participate in development.

Step 8. Ask what if? But this
question requires lateral thinking and no area of the hospital is off
limits. Looking at the configuration of the clinical and medical services, what
could go away tomorrow because it can be done at a lower cost with higher
quality in a different setting? By understanding
those factors now comes the innovation of how can I be the first to meet that
change head-on. It is a recognition that one is not in the hospital business
but the healthcare business.

Step 9. Use social networks. Follow trends and ask a question on groups like LinkedIn, Facebook, and Twitter. Ask what people want to
see or what they think the next new big idea will be. Many early adopters and
innovators will be more than happy to answer your questions. I haven’t met an innovator that doesn’t like to talk about what
they are doing.

Step 10. Have regular
brainstorm meetings where one generates a lot of
new ideas. Use diverse groups from within the hospital and include a
provocative outsider like a vendor or key customer.

The ways to innovate are legendary. But one thing innovators
have in common is that they recognize the opportunity
for innovation driven by meeting the needs of a market because other won’t.
Don’t wait for someone else to do it for you.

Sunday, March 20, 2016

A health system is in trouble. It was disclosed this week in several news outlets of a $186 million dollar loss due to revenue write-offs, malpractice settlements, ineffective revenue cycle management, outmoded billing and collection polices-processes, etc. See “Presence Health CEO tending to ailing hospital chain”, Chicago Tribune, March 20, 2016. Also telling was the statement of declining inpatient and outpatient utilization.

So what is planned?

üLayoff 250 support and administrative staff with a total reduction target of 700 FTEs mostly through attrition.üRevamped revenue cycle management, improved collection and billing processes-procedures.üRaising prices.üReplace key senior leadership holdovers from the previous leadership team.üTrot out “key” board members to support the changes.üSubtlety throws the old leadership team under the bus.

Leadership hit the standard checklist of what to do. I do understand that these are the actions to be taken and communicated to the bondholders, given that Presence Health is in violation of several bond covenants of their billion dollar debt.

But no mention was made of how they intend to turn around the declining utilization. And beyond the actions mentioned above required to stabilize the business, that is what is at the heart of the matter.

Which brings me in a roundabout way to the original question of what is marketing’s role in assisting the turnaround of the system?

Marketing can be an integral part if leadership has the wisdom and foresight to take bold action and include marketing in the efforts. And this isn’t a PR effort or meaningless advertising. It is a system marketing opportunity to drive meaningful change in experience, engagement and value, running concurrently with the business changes.

And this is critical for the long-term survival of the system.

Why? Because Presence Health still lives in a predominately fee-for-service environment. If they don’t have patients, they cannot bill for services or collect co-pays and deductibles no matter who the payor.

If physicians are not sending their patients for services and the healthcare consumer is not choosing them for care, then a long hard look is needed with marketing involvement across the dimensions of experience, engagement, and value with an eye towards improvement.

The marketing work also means rewriting the system value proposition and answering the questions of why should a patient or physician choose the system in a contextual and meaningful way. Why should doctors and consumers select the system based on value, price, experience, and engagement?

That’s the question needing to be answered going forward.

Are the current marketing efforts working? There may be some disconnect between the business strategy and current marketing campaigns. Marketing today should not be about shiny new buildings, the ability to treat varicose veins, or claiming clinical excellence. There are reasons why physicians and patients choose not to use the health system.

It’s about proving value, engaging physicians, patients and the healthcare consumer in a meaningful and lasting way as well as providing an experience that creates loyalty.

But once this situation is stabilized, just how do you plan to grow? Growth is good.

Best of luck raising prices and asking patients, healthcare consumers and payers to pay more without real improvements in the physician experience, patient engagement/experience, and marketing without meaningful actions and content.

And no defense or excuses are offered why providers are apparently so bad at creating and managing an acceptable level of experience for patients either. I think we all get that the patient experience is complex and interrelated. The complexity of the experience concept is illustrated by the chart below. There are over 147 experience touch-points of experience with a provider across the patient experience journey.

But what seems to be happening each time a new experience survey or CEO top issues list comes out, leadership talks about it, makes profound statements about the importance of experience without much action, or token action at best.

That is the old way of doing business.

Where to start? Well, at the beginning because there are no easy button answers.

It all begins with the culture.

Patient experience improvement doesn’t happen overnight, especially in healthcare enterprises that have a cultural focus that it’s all about us, instead of a culture that focuses on the external patient or healthcare consumer. It isn’t driven by technology though that is a tactic and solution. Nor a one and done a training program. And experience is not a passing mention of the business or strategic plan.

The time between understanding and action in the healthcare consumer or patient experience expectations can be measured in minutes, not days or months or when one gets around to it. Notoriously slow in adapting is to new technologies and trends; providers need to start managing the experience across all touch-points.

Sunday, March 6, 2016

In 2015, it was estimated that the healthcare consumer will pay over $350 billion for healthcare in the form of insurance premiums, deductibles and co-pays. I have often written that an individual if they were willing to spend at least a little time and effort, could put together a quality, affordable medical network.

In some cases, spending a little time understanding the systems in an insurance plan as well can save time, money and heartburn too.

Most providers resist change and accountability.

Healthcare providers will continue to resist change unless there is an economic incentive. Hospitals and system are buying physician practices, merging and acquiring to lock in market share which seems to be resulting in higher prices leading to higher insurance premiums, co-pays, and deductibles.

I know, here comes the how can you say that? Easy, name me one hospital merger in a market that resulted in lower prices, consolidation of clinical services or any economies of scale that led to a decrease in the cost of care that they claim will happen? You can’t.

Healthcare consumerism is really about the individual’s ability to make a choice that benefits them, not the healthcare provider.

With less than full transparency on the part of healthcare providers to make it easy for the healthcare consumer to find the information they need to make an informed decision and choice, alternatives have been developed and launched.

On those easy to use sites, the healthcare consumer is finding information in their buyer’s journey. Providers are over a barrel. Few choices remain over the next few years for providers who do not become the high quality, cost-efficient, responsive provider.

Now it will take a little work on the searchers part pointing and clicking, but here are the websites that will show all the information consumers and patients need to make informed decisions. In the end, with information, the healthcare consumer can avoid poor performing and costly healthcare providers.

How do the hospitals in my area compare?

With Hospital Compare by CMS, the healthcare consumer finds understandable information that you need for choosing a hospital for your network. Add you zip code in the search box, and up will come the listing of hospitals in your area. Select three for comparisons. Take the time and go through the tabs.

I did and found that despite all three hospitals claim to high quality, caring about me and great care with all the latest technological gizmos and new buildings, I live in a sea of hospital mediocrity. Don’t become a victim of false advertising. Demand better, because your life may very well depend on it.

How much can I expect a test or procedure to cost me?

In another market development benefiting the consumer is a small but significant victory in cost transparency, with Guroo.Guroois one of the sites providing charge information for 78 standard procedures, based on data from the Health Care Cost Institute database. Search along procedure, condition or test and then enter your zip code. Next thing you know, here comes the cost information for your area. And more hospital pricing websites come online each and every day.

How do I know if my doctor or hospital receives payments from healthcare vendors?

Centers for Medicare and Medicaid Services Open Payments. On this website, you can search for your doctor(s) and hospitals(s) to see the payments by vendors like medical device companies, pharma, etc. Now this doesn’t mean that there is a conflict of interest on the part of hospitals or doctors. But since they aren't transparent, then you need to find the information. It could potentially impact the care and choices they are making.

What are others saying about the hospital?

Consumers turning to Yelp reviews are an everyday fact of life. Some are good. Some are bad, and some are really bad. The point is not how few reviews, but it’s a reflection of the care experience and how the provider addressed the concern. If one is not addressing the concern publically with a response on Yelp, then the provider is flunking the consumer test. No response is undercutting the experience, marketing messages, and brand. All it takes is a “how can we contact your response to learning more”.

Still think consumers aren’t going to exercise their options when they learn all this?